Geriatric Medicine

The Falls and Balance Clinic aims to reduce fall risk for elderly persons by identifying and correcting risk factors.

This starts with a comprehensive functional (visual, sensory, reaction time, mobility), and physiologic profile (muscle strength and balance) assessment together with a review of relevant health issues.

Besides management of health and other issues, an individualised assessment by physiotherapist is a major part in management of falls and balance. Sets of strengthening and balance exercise or group exercise programmes will be discussed and prescribed according to the individual's need.

Who will benefit from the Falls and Balance Clinic?

If you are above 65 years old, able to walk and

• fell more than twice in the past 12 months, or
• persons who observe your walking are concerned that you might fall, or
• have a significant fear of falling based on these questions:
  • Do you avoid going out or restrict your routine activities because you are afraid of falling?
  • Do you feel like you are going to fall on getting up or walking?

If the answer is “Yes”, do discuss with your polyclinic doctor or GP on obtaining a referral, or visit our Community Health Posts for more information.

Frailty is recognised as a lens through which all patients and diseases are viewed, especially in Geriatric Medicine as it can be reversed in early stages. Frailty guided evaluations are integrated into daily practice right from first contact in the emergency department or in an outpatient clinic.

For patients with potentially reversible frailty, frailty classes by a team of physiotherapist, dietitian and geriatrician are available in the Specialist Outpatient Clinic to restore strength, provide nutritional advice, optimise chronic disease management and provide preventive therapeutic options.

For patients with advanced frailty who are admitted to the hospital, Geriatric Frailty Unit provides a listening clinic for families to understand the condition of their loved ones, elicit values and preferences to maximise quality of life and a personalised care plan.

The Dementia team provides diagnosis, care and management for people with cognitive impairment in the following settings:

• Specialist Outpatient Clinics
• Inpatient wards
• Community in collaboration with community partners

Inpatient Dementia Wards: CAMIE (KTPH/Acute) & CARMIE (YCH/Subacute)

CAMIE (Care for the Acute Mentally Infirm Elder) is an acute care service provided at KTPH for patients with dementia with confused behaviours who require hospitalisation for the treatment of a variety of medical problems. The common reasons why patients with dementia need hospital admission include falls, fractures, pneumonias, urinary tract infections, challenging behaviours, decline in function and more.

CAMIE adopts a person centred care philosophy that upholds the dignity and autonomy of the patient, and promotes quality of life through enhanced care that adopts a no physical restraints policy. Do watch this video to understand about the CAMIE and no restraints care.

CAMIE has a sister ward, CARMIE (Comprehensive Assessment & Rehabilitation of the Mentally Infirm Elder), nestled in Yishun Community Hospital which similarly cares for patients with dementia with less acute medical conditions or who need physical rehabilitation.

Dementia Friendly Community (DFC)

10% of Singaporeans aged 60 and above suffer from dementia. By age 85, up to 50% may succumb to dementia. There are 45,000 persons with dementia in Singapore today and it is projected to more than double to 103,000 by 2030. Although dementia causes intellectual and functional decline with diminished independence, it does not change the desire in people with dementia to continue to lead normal lives, the way they have always lived. They will continue to visit food centres, use public transport or engage in banking services. However, they may encounter problems in the process such as forgetting to pay for their purchase, or over-buy groceries without realising, only because deep down they still see themselves as providers for their families.

Khoo Teck Puat Hospital works with Lien Foundation and Agency for Integrated Care (AIC) to build Singapore's first dementia-friendly community right here in Yishun: The “Forget Us Not” initiative aims to foster a kampong spirit where we help persons with dementia continue to lead normal and dignified lives in the community. Let us not forget our loved ones, even as they seem to forget us. Join us to become a dementia friend to build a dementia-friendly community. For more details: https://www.forgetusnot.sg

Aid for Dementia Diagnosis (ADD)

This is an expert system designed to facilitate the diagnosis of Dementia.

As ADD serves primarily as a diagnostic aid, the physician should always exercise clinical judgment with respect to the conclusions and recommendations offered by the system. By using the application or site, you agree that the developers of ADD shall not be liable for any damages arising from the results given by the application.

Your feedback will be greatly appreciated, you may send them to ktph.memorycare@ktph.com.sg.

Credits: Geriatric Centre and Department of Medical Informatics from Khoo Teck Puat Hospital and National University of Singapore, School of Computing.

The aim of Palliative Care is to improve the quality of life for patients and their families faced with advanced progressive life-limiting illnesses, through the prevention and relief of suffering and the provision of total active care for physical, psychological and spiritual problems.

Doctors and nurses from the Palliative Care Service provides expert and compassionate care with an integrated team of allied health workers, pharmacists, social workers, psychologist and psychiatrist to provide holistic care in:

• Symptom management - E.g. pain, breathlessness
  
• Communication and support to patient and family
• Guidance regarding medical decisions
• Advanced care planning
• Guidance and arrangements for care at home, in community hospitals, inpatient hospice or nursing homes
• End of life care
• Psychosocial and spiritual support
• Grief and bereavement support
  

These are provided through direct management, support to primary physicians or collaboration with community partners to bring care to wherever patient is located.

1. Inpatient Palliative Care Beds: Dedicated beds in acute hospital wards managed by Palliative Medicine Physician for patients who require equipments available only in acute hospitals.
2. Specialist Outpatient Palliative Care Clinics: Palliative Medicine Physicians provide first visit assessment or follow up for symptom mangement, adjustment of chronic disease care, education and skills training for caregivers, recommendation and liaison for equipment and services to meet patient's needs.
3. Community Hospital Palliative Care Beds: For patients who have completed acute hospital treatment and have progressed to subacute care to finetune symptom control or optimise function and chronic disease adjustments, to provide caregiver upskilling to go home or to be ready for transfer to inpatient hospice or nursing home.
4. Community Care: We support patients who wish to spend their time in the company of their loved ones and families at home by delivering care through hospice organisations (Singapore Cancer Society and HCA Hospice Care ) and AIP-CCT seamlessly through home visits, Telehealth and case discussions.
   

For more information on Palliative Care, please visit Singapore Hospice Council